Provider Demographics
NPI:1417003690
Name:FRAZIER, FLOYD HAROLD (LCPC)
Entity Type:Individual
Prefix:MR
First Name:FLOYD
Middle Name:HAROLD
Last Name:FRAZIER
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 W IRONWOOD DR
Mailing Address - Street 2:SUITE 314
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814-2660
Mailing Address - Country:US
Mailing Address - Phone:208-765-9585
Mailing Address - Fax:
Practice Address - Street 1:1200 W IRONWOOD DR
Practice Address - Street 2:SUITE 314
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814-2660
Practice Address - Country:US
Practice Address - Phone:208-765-9585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID286101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health